Children’s hospital costs to have ‘real implications’ for health service for years to come

This morning's lead story from Martin Wall is likely to provide for interesting reading across the environs of Leinster House.

In his piece, Wall details stark warnings given by the HSE where they say that it will be almost impossible to deliver planned multibillion-euro investments in new healthcare facilities in the coming years because of cost overruns at the national children's hospital.

This issue, along with having to deal with cost overruns from the new children's hospital in the years 2020 to 2022, "has made what was a very difficult situation now almost impossible", the HSE told the Department of Health last month.

The crux of the issue is this: the cost over-runs at the national children’s hospital - which will now cost in the region of €1.7 billion once things like IT are factored in - will have real and tangible implications for the health service in years to come.

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That matters both because cuts will likely need to be made to accommodate this over-run, but also because ministers have previously said that no development would be cancelled or delayed.

They said that money would be found by rearranging funding this year from a number of other projects.

The Taoiseach previously said: “We anticipate it will mostly be achieved by postponing or delaying projects by two or three months rather than having to cancel any particular project but that has yet to be worked out,” he said, referring to how the Government would address the over-runs.

Wall’s piece shows that the over-run is set to have implications for the health service not just in 2019 but throughout the next four or five years.

The concerns are laid bare in letter to the secretary general of the Department of Health from the then acting director general of the HSE Anne O’Connor.

There is more bad news in store today, too.

The Public Accounts Committee will hear this morning how, in the first three months of the year, the HSE recorded a total overrun of more than €103 million. This followed a €600 million deficit last year.

The level of overspending this year in health is causing considerable angst amongst ministers who feel that the Department of Health has not quite got the message about the need to remain in its budget.

In recent days the Government has pointed out that, because of the looming threat of a no-deal Brexit, Ireland’s hard-won recovery could be chastened and instead of scoring a surplus we could find ourselves in a position where we might need to borrow billions.

And we cannot keep relying on “volatile” corporation tax receipts, they say.

Basically, the money for continuous health overruns in the Department just may not be there any more.

What does that mean? Cuts within the HSE to ensure that the organisation breaks even across the country.

And that is the politically unpalatable reality that beckons as we head towards the second half of 2019.

Members of the Public Accounts Committee are likely to this morning grill the Department and the HSE on the capital funding dilemma in relation to the children’s hospital as well as the emerging financial issues.

For his part, the new director general of the HSE Paul Reid will tell TDs that senior managers in the HSE will be held to account.

His opening statement, seen by The Irish Times, says the organisation wants to “maximise the safety of the services it can deliver within the available budget.”

“Thereafter the priority, consistent with the Sláintecare programme, is to deliver on the activity, access, improvement and other targets set out in the NSP albeit this must be done within the affordable staffing level and without exceeding the overall budget.”

“Delivering on these priorities will require a significantly enhanced focus on financial management. This includes better controls on the management of agency, overtime and overall staffing levels and pay costs. Senior Managers will be supported and held to account in this regard.”

Keep an eye onirishtimes.com today for more developments on this front.

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PLAYBOOK

Dáil Éireann

The Minister for Business Heather Humphreys will take parliamentary questions at 10.30am

Leader’s Questions is up at noon

There will be questions on promised legislation at 12.32pm

Weekly divisions are at 1.47pm and then Government business at 2.25pm: this will include statements on the Government’s climate action plan.

The CervicalCheck Tribunal Bill 2019 is also at second stage

At 17.15pm, topical issues are up

Time is scheduled for a private members’ Bill just after 6pm and this week it is the Social Welfare (Miscellaneous Provisions) (Amendment) Bill 2017 from Sinn Féin’s John Brady. This Bill is aimed at stopping the restructuring of MABS.

The Dáil adjourns for the week at 8.03pm

Seanad

Commencement Matters will be taken at 10.30am

The Order of Business is up next at 11.30am

At 11.30 there are motions on animal health levies and a motion on the Social Welfare Consolidation Act 2005. The Seanad will also discuss the Redress for Women Resident in Certain Institutions (Amendment) Bill 2019 which is at committee stage. Under this Bill, lump sums paid to women under a redress scheme will not be taken into account in nursing home support assessments.

Committees

At 9am, the Select Committee on Justice and Equality meets to consider the Gender Pay Gap Information Bill 2019 with the Minister for Justice Charlie Flanagan.

The Public Accounts Committee also meets at 9.00am to hear from the Department of Health and the HSE in relation to, amongst other matters, funding for the health service

At 9.30am the Joint Committee on Foreign Affairs and Trade, and Defence will hear from representatives from the Permanent Defence Force Other Ranks Representative Association (PDFORRA) on recommendations from the Public Service Pay Commission

The Joint Committee on Foreign Affairs and Trade will hear from the Tánaiste Simon Coveney about the Foreign Affairs Council at 2pm